Overview Of Gender Identity Disorder
The best way to describe this disorder is by asking a simple question: what is worse than feeling like your brain and body are two different sexes? This is what many children and adults who have GID deals with on a daily basis. Gender Identity Disorder is a disorder that is diagnosed in childhood and mostly disappears before adulthood. The disorder will be discussed by the description, the DSM classification, homosexuality vs. transsexual results, case studies, and treatment.
Gender Identity Disorder is described as the identification with members of the opposite sex who has persistent discomfort with one’s biological sexual identity, and strong desire to change to the opposite sex (Butcher, Mineka, Hooley (2010). In other words a person feels as if they were born the wrong sex.
To better get an understanding of the disorder, the difference between gender, gender role, gender identity and sexual orientation need to be defined. Gender is defined by the psychological and cultural characteristics that determine the sex of an individual (Schechner 2010). In other words, how the person behaves and thinks determines if the individual is male or female in their brain. Gender roles are described by the attitudes, behaviors, and personality traits that are given in a cultural and historical context (Schechner 2010). Does the child play with female or male toys, and do they act like a girl or a boy in behavior. Gender identity is the perception of one’s self as male or female and the sexual orientation is what sex the person is attracted to.
Also the terms intersex, transgender, transsexual, bisexual, and homosexuality needs to be explored as well. Intersex is described as having sexual characteristics of both male and female (Collins English Dictionary 2009). Transgender is described as wanting to become the other sex (Collins English Dictionary 2009). Transsexual is described as individuals who have already gone sex change and is living as the other sex (Dictionary.com 2010). Bisexual means an attraction to both sexes, and homosexuality is when a person like the same sex.
The stats for this disorder is unknown, to date there are no stats listed for number of children and adults classified with Gender Identity Disorder (GID). What is known is that one in 30,000 males and one in 100,000 females seek gender reassignment surgery which some GID patients complete the procedure (Colenso 2008). The cause of this disorder is also unknown but there is plenty of research that points to chromosomal genetic abnormalities, hormonal imbalances during fetal and childhood development, defects in normal bonding and child rearing, or a combination of the factors (WEBMD 2010). Also, it is stated that children as early as 2years-4years can show syndromes of GID, but it is not usually diagnosed until ten years old. Also usually most children with the disorder will grow out of the main syndrome (wanting to be the other sex) by adulthood, only a few end up having the disorder as adults.
Diagnostic and Statistical Manual of Mental Disorders Classification (DSM)
GID in DSM III is split into two different disorders based on age. GID was described only for children and adolescents. Adults with GID were considered to be Transexualism or transgenderism (Shechner 2010). In DSM IV the disorders were combined and made in only one classification disorder of GID. However, the GID disorder in the DSM IV does have two classifications. One is GID and the other is GID Not Otherwise Specified. The GID Not Otherwise Specified includes intersex conditions, transient stress-related-cross-dressing behavior, and persistent preoccupation with eliminating any physical trait that they do not want without a desire to acquire the other sex’s characteristics (DSM IV 1994).
In the DSM V, GID was taken out of the DSM and instead replaced with Identity Dysphoria. They took Gender Identity Disorder out due to its stigmatization of the individuals, making some seem as if they were attacking individuals with the disorder.
So what is the new diagnosis? Identity Dysphoria is described as feeling as if an individual feels as if they are the wrong sex. So basically, same definition just they changed the name but it is still the same.
The Outlook for GID Children
The old thought was that most of the children diagnosed with GID will end up being a transsexual, but research has pointed in other directions. In fact it seems like most children with GID turn out to be homosexual or bisexual. In a research with 66 feminine boys and 56 normative boys (14years-21years) found that 75% had homosexual fantasies, as well as 80% of GID boys and 4% of normative boys had homosexual or bisexual behavior (Shechner 2010). In a follow-up only one of the boys ended up getting sex reassignment surgery (Shechner 2010).
Studies involving GID girls are rarer and only one is shown to date. The study used 31 masculine girls. It was found that at enrollment 60% of the girls met the criteria for the disorder and 40% had a subthreshold of GID (Schechner 2010). It was shown that the highest percentage of homosexuality was 32% in fantasy and 24% were classified as having behavioral or lesbian in behavior (Schechner 2010). Note, these were from two different research parties and the information is limited on the female research paper so the percentages of GID male homosexuality to GID female homosexuality can not to be compared.
Even though homosexuality is the biggest result of GID than transgenders, most of the research is on transgenders. University of Florence found that male-to-female transsexuals need to be analyzed by two factors. The first factor is sexual orientation and the second one is the behavioral psychological correlates of early GID development (University of Florence). The results showed that a positive correlation occurred between factors two and feminine BSRI scores yet factor one and factor two did not correlate. The university research team found that both factors play a part in male-to-female transsexuals.
In regard to treatment, there is no acceptable professional treatment for GID. There are therapists and psychologists that the GID patient can see to help the patient accept that they are different and start learn to feel comfortable. Again many of the therapies are for transsexuals and one of the newest ways is a method called “Gender Role Conflict Theory,” and is split up into five sections: one-awareness, two-seeking information, three-exploration, four-disclosure, and five-integration (Wester, McDonough, White, Vogel, Taylor 2010). This really only are for those going through transgender reassignments:
Stage one is described as the awareness of the consciousness of the internal sense of feeling different and realizing that in fact one is different (Wester, McDonough, White, Vogel, Taylor (2010). So in other words the transsexual person explore why they do not fit the social norms or their biological gender roles. This gives the client a time to explore why they are different and why that affects them socially and emotionally. Stage two is about seeking information about why they are the way they are. The clients are eager to research GID and transgenderism, and seek information from other transgender people to get a better understanding. Stage three is their exploration of how transgenderism affects their lives. Stage four is the transgender accepting their true identities. This is always a turbulent time for most transgender and usually it is recommended that they start with the people they trust the most (Wester, McDonough, White, Vogel, Taylor (2010). Stage five is the full integration of the transgender identity that the client determines. This is the stage where the client will say “I am not Jenny anymore; I’m Jacob, and Jenny is never coming back.”
Though the description, the DSM classification, homosexuality and transsexual results, case studies, and treatment it is easy to say that Gender Identity Disorder is an interesting disorder. Surprising the disorder has been modified in the DSM two times and in the upcoming DSM (DSM V) it will be modified again. Children with GID will have a better chance of becoming homosexuals than a transgender. There is no treatment for GID alone, but instead it is focusing on helping the person with GID deal with their disorder and bad connotations that come with the disorder. The causes are still unknown but the symptoms could be awkward for both the people with GID and those around them. Even though social norms were not discussed, it does add another dimension that can not be ignored. The GID children and adults need support from their society and peers in order to stop self-negative feelings about themselves.
Butcher, James N., Mineka, Susan, Hooley, Jill M. (2010). Sexual Variants, Abuse, and Dysfunctions. In Ally and Bacon (Eds.), Abnormal Psychology(pg 432-436)
Colenso, Maria (2008). How Gender identity Disorder Works. HowStuffWorks.com.
intersex. (n.d.) 2009 Collins English Dictionary - Complete & Unabridged 10th Edition. Retrieved October 04, 2010, from Dictionary.com website: http://dictionary.reference.com/browse/intersex
The Diagnostic and Statistical Manual of Mental Disorders 4th edition, DSM-1V (1994). Washington, DC: American Psychiatric Association.
Pheil, Time, Pheil, Andrea (2005). Gender Identity Disorder DSM IV Criteria. Gender Identity Disorder Sanctuary. http://www.mhsanctuary.com/gender/dsm.htm
Shechner, T. (2010). Gender Identity Disorder: A Literature Review from a Developmental perspective. The Israel Journal of Psychiatry and related Sciences, 47(2): 132-138.
Transsexualism. (n.d.). Dictionary.com Unabridged. Retrieved October 04, 2010, from Dictionary.com website: http://dictionary.reference.com/browse/transsexualism
University of Florence (2010). Sexual Health; Studies from University of Florence, department of Clinical Physiopathology Describe New Findings in Sexual Health. Psychology & Psychiatry Journal: pg 277.
WEBMD (2010). Gender Identity Disorder. WEBMD: Better Information, Better Health. http://www.webmd.com/sex/gender-identity-disorder
Wester, Stephan R., McDonough, Tracy A., White, Maureen, Vogel, David L., Taylor, Laureena (2010). Using Gender Role Conflict Theory in Counseling Male-to-Female Transgender Individuals. Journal of Counseling and development: JCD, 88:2, 214-220